Health care discrimination, sex behavior disclosure, and awareness of pre-exposure prophylaxis among Black men who have sex with men.

Perceived health care–related discrimination and disclosure of same-sex sex behaviors to health care providers may act as barriers to awareness of preexposure prophylaxis (PrEP) for Black/African American men who have sex with men (BMSM). Given the elevated rates of HIV transmission among young BMSM in particular, age is likely an important factor for determining the correlates of PrEP awareness unique to BMSM of different ages. We recruited 147 BMSM (M age = 30.6 years, SD = 10.3 years) located in the southeastern United States from gay-identified bars, clubs, bathhouses, parks, and street locations, via online classifieds (e.g., Craigslist) and social media (e.g., Facebook). Participants completed surveys that included questions about demographic characteristics, perceived health care–related discrimination, disclosure of same-sex sex behavior to health care providers, and PrEP awareness. Perceived health care–related discrimination was significantly, negatively associated with PrEP awareness, and same-sex sex behavior disclosure to health care providers was significantly, positively related to awareness of PrEP among BMSM. A moderation analysis, with participant age as the moderator, revealed that higher perceived health care–related discrimination was significantly, negatively associated with PrEP awareness beginning at 30.2 years of age, and that the relationship strengthened as age increased. Perceived health care–related discrimination plays a particularly important role in PrEP awareness for BMSM who are 30 years of age and older. Discrimination in health care settings may impact BMSM’s ability, particularly those who are older, to access PrEP information. Health care professionals must establish procedures for identifying appropriate patients for PrEP, and prioritize addressing the psychosocial factors that impede PrEP awareness for their BMSM patients. (PsycINFO Database Record (c) 2018 APA, all rights reserved)